Evaluation of the Effectiveness of Episiotomy Repair Training with Calf Tongue Simulator for Midwifery Students

Yıl 2023, , 461 - 472, 28.09.2023

Hülya Türkmen , Sibel Karaca Sivrikaya

https://doi.org/10.53424/balikesirsbd.1145941

Öz

Aim: To determine whether the use of calf tongue simulator in episiotomy repair increases the knowledge and skill level of the students. Materials and Methods: The study in the form of a single-group “pretest-posttest” pretrial was carried out in April 2019 with students of midwifery (n=66). During episiotomy repair simulation training, suture techniques (simple suturing, locking loop suturing and vertical matrix) were shown by using calf tongue simulators. The data were collected by using a personal information form, while the Episiotomy Knowledge Levels Assessment Form and Episiotomy Repair Skill Levels Assessment Form were used for the pretest and posttest. Results: As a result of the simulation training, increases were observed in episiotomy knowledge and repair skill levels in comparison to the pre-training period (p<0.05). Conclusion: As a result of the study, it was determined that episiotomy repair training given to students with a calf tongue simulator achieved increases in their knowledge and skill levels in comparison to pre-test result. Simulator examples that can be used for episiomy repair can be added to the midwifery education curriculum.

Anahtar Kelimeler

Episiotomy, Calf tongue simulator, Simulation, Midwifery students, Skills

Ebelik Öğrencilerine Verilen Dana Dili Simülatörü ile Epizyotomi Onarımı Eğitiminin Etkinliğinin Değerlendirilmesi

Öz

Amaç: Epizyotomi tamirinde dana dili simülatörü kullanımının öğrencilerin bilgi ve beceri düzeyini arttırıp arttırmadığını belirlemektir. Gereç ve Yöntem: Tek grup “öntest-sontest” deneme öncesi modeli tipindeki araştırma Nisan 2019 tarihinde ebelik öğrencileri ile gerçekleştirilmiştir (n=66). Epizyotomi tamiri simülasyon eğitiminde dana dili simülatörü kullanılarak sütür teknikleri gösterilmiştir. Verilerin toplanmasında kişisel bilgi formu, ön test ve son test için Epizyotomi Bilgi Düzeyini Değerlendirme Formu ve Epizyotomi Tamiri Beceri Düzeyini Değerlendirme Formu kullanılmıştır. Bulgular: Simülasyon eğitimi sonrasında eğitim öncesine göre epizyotomi bilgi düzeyi ve epizyotomi tamiri beceri düzeylerinde artış olduğu saptanmıştır (p<0.05). Sonuç: Çalışma sonucunda ön-test sonucuna göre öğrencilere danadili simülatörü ile verilen epizyotomi tamiri eğitiminin öğrencilerin bilgi ve beceri düzeyinde artış sağladığı belirlenmiştir. Ebelik eğitim müfredatına epizyotomi onarımı için kullanılabilecek simülatör örnekleri eklenebilir.

Anahtar Kelimeler

Epizyotomi, Dana dili simülatörü, Simülasyon, Ebelik öğrencileri, Beceri

Kaynakça

• Barjon, K., Mahdy, H. (2022). Episiotomy. StatPearls Publishing. PMID: 31536281. Bookshelf ID: NBK546675
• Banks, E., Pardanani, S., King, M., Chudnoff, S., Damus, K., & Freda, M. C. (2006). A surgical skills laboratory improves residents’ knowledge and performance of episiotomy repair. American Journal of Obstetrics and Gynecology, 195, 1463-1467. https://doi.org/10.1016/j.ajog.2006.05.041
• Besen, M. A., Rathfisch, G. (2020). The effect of suture techniques used in repair of episiotomy and perineal tear on perineal pain and dyspareunia. Health Care For Women International, 41(1), 22-37.
• Besen, M. A., Rathfisch, G. (2019). Perinal Trauma And Repair During Childbirth: Evidence-Based Approaches. Gazi Journal of Health Sciences, 4(3), 1-11
• Blondel, B., Alexalder, S., Bjarnadottir, R. I., Gissler, M., Langhoff-Rose, J., Novak-Antolic, Z., et al. (2016). Variations in rates of severe perineal tears and episiotomies in 20 European countries: A study based on routine national data in Euro-Peristat Project. Acta Obstetricia et Gynecologica Scandinavica, 95, 746–754.
• Brady, S., Bogossian, F., & Gibbons, K. (2015). The effectiveness of varied levels of simulation fidelity on integrated performance of technical skills in midwifery students-a randomized intervention trial. Nurse Education Today, 35, 524-529. https://doi.org/10.1016/j.nedt.2014.11.005
• Burke, H., & Mancuso, L. (2012). Social cognitive theory, metacognition, and simulation learning in nursing education. Journal of Nursing Education, 51(10), 543-548.https://doi.org/10.3928/01484834-20120820-02
• Cooper, S., Cant, R., Porter, J., Bogossian, F., McKenna, L., Brady, S., & Fox-Young, S. (2012). Simulation based learning in midwifery education: A systematic review. Women and Birth, 25, 64-78. https://doi.org/10.1016/j.wombi.2011.03.004
• Çalım, S. I., & Öztürk, E. (2018). Using of simulation in midwifery skils education: a systematic review. International Refereed Journal of Gynaecological Diseases and Maternal Child Health, 12, 143-168. https://doi.org/10.17367/JACSD.2018.1.3
• Dancz, C. E., Sun, V., Moon, H. B., Chen, J. H., & Özel, B. (2014). Comparison of 2 simulation models for teaching obstetric anal sphincter repair. Simulation in Healthcare, 9, 325–30. https://doi.org/10.1097/SIH.0000000000000043
• Demirel, G., Evcili, F., Kaya, N., & Doganer, A. (2020). The effect of episiotomy repair simulation on the anxiety and self-efficacy levels of midwifery students. Journal of Midwifery and Reproductive Health, 8(1), 2050-2057.
• Eston, M., Stephenson-Famy, A., McKenna, H., Fialkow, M. (2020). Perineal Laceration and Episiotomy Repair Using a Beef Tongue Model. MedEdPORTAL, 16. https://doi.org/10.15766/mep_2374-8265.10881
• Fergusson, L., & Shahtahmasebi, S. (2014). Enabling new graduate midwives to manage emergencies confidently: a pilot study. Dynamics of Human Health, 1(2). ISSN 2382-1019. http://journalofhealth.co.nz/?page_id=300
• Franscisco, A. A., Kinjo, M. H., Bosco, C. S., Silva, R. L., Mendes, E. P. B., & Oliveira, S. M. J. V. (2014). Association between perineal trauma and pain in primiparous women. Revista da Escola de Enfermagem da Usp, 48, 39–44. https://doi.org/10.1590/S0080-623420140000600006
• Friedman, A. M., Ananth, C. V., Prendergast, E., D’Alton, M. E., & Wright, J. D. (2015). Variation in and factors associated with use of episiotomy. JAMA, 313(2), 197–199. https://doi.org/10.1001/jama.2014.14774
• Guler, H., Cetin, P., Yurtsal, Z. B., Cesur, B., Bekar, M., Uçar, T., et al. (2018). Effect of episiotomy training with beef tongue and sponge simulators on the self-confidence building of midwifery students. Nurse Education Practice, 30, 1–6. https://doi.org/10.1016/j.nepr.2018.02.004
• Illston, J. D., Ballard, A. C., Ellington, D. R., & Richter, H. E. (2017). Modified beef tongue model for fourth-degree laceration repair simulation. Obstetrics & Gynecology, 129(3), 491-496. https://doi.org/10.1097/AOG.0000000000001908
• Junior, M. D. C., & Júnior, R. P. (2016). Selective episiotomy: indications, techinique, and association with severe perineal lacerations. Revista Brasileira Ginecologia e Obstetetricia, 38, 301-307. https://doi.org/10.1055/s-0036-1584942. ISSN 0100-7203
• Kapucu, S., & Bulut, H. (2011). Turkish nursing students’ views of their clinical learning environment: A focus group study. Pakistan Journal of Medical Sciences, 27(5), 1149-1153. https://www.researchgate.net/publication/285746571
• Karaahmet, A. Y., Yazıcı, S. (2017). The Current Stage of Episiotomy. Journal of Helath Sciences and Professions, 4(1), 57-63.
• Kempster, C., McKellar, L., Steen, M., & Fleet, J. (2018). Simulation in midwifery education: A descriptive explorative study exploring students’ knowledge, confidence and skills in the care of the preterm neonate. Women and Birth, 30(S1), 1–47. https://doi.org/10.1016/j.wombi.2017.08.034
• Knobel, R., Volpato, L. K., Gervasi, L. C., Viergutz, R. A., & Júnior, A. T. (2018). A simple, reproducible and low-cost simulator for teaching surgical techniques to repair obstetric anal sphincter injuries. Revista Brasileira Ginecologia e Obstetetricia, 40, 465–470. https://doi.org/10.1055/s-0038-1668527
• Koçak, Y. Ç., Can, H. Ö., Yücel, U., Akyüz, M. D., Turfan, E. Ç. (2017). Academic and Physical Profile of Midwifery Department in Turkey. Journal of Health Science and Profession, 4(2), 88-97.
• Kordi, M., Rashidi Fakari, F., Khadivzadeh, T., Mazloum, S. R., Akhlaghi, F., & Tara M. (2015). Effects of web-based training and educational simulation on midwifery students’ self-confidence in postpartum hemorrhage management. Journal of Midwifery and Reproductive Health, 3(1), 262-268. https://www.researchgate.net/publication/281446609
• Kumar, A., Nestel, D., East, C., Hay, M., Lichtwark, I., McLelland, G., …, & Fernando, S. (2018). Embedding assessment in a simulation skills training program for medical and midwifery students: A pre-and post-intervention evaluation. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58, 40-46. https://doi.org/10.1111/ajo.12659
• Lathrop, A., Winningham, B., & VandeVusse, L. (2007). Simulation-based learning for midwives: background and pilot implementation. Journal of Midwifery & Women’s Health, 52(5), 492-498. https://doi.org/10.1016/j.jmwh.2007.03.018
• Lendahls, L., & Oscarsson, M. G. (2017). Midwifery students' experiences of simulation- and skills training. Nurse Education Today, 50, 12-16. https://doi.org/10.1016/j.nedt.2016.12.005
• Mckenna, L., Bogossian, F., Hall, H., Brady, S., Fox-Young, S., & Cooper, S. (2011). Is simulation a substitute for real life clinical experience in midwifery? a qualitative examination of perceptions of educational leaders. Nurse Education Today, 31, 682-686. https://doi.org/10.1016/j.nedt.2011.02.014
• Nghitanwa, E. M., Endjala, T., & Hatupopi, S. K. (2019). Simulation-based training in nursing and midwifery: a literature review. International Journal of Medical Science and Health Research, 3(2), 37-46. ISSN: 2581-3366.
• Patel, M., LaSala, C., Tulikangas, P., O'Sullivan, D. M., & Steinberg, A. C. (2010). Use of a beef tongue model and instructional video for teaching residents fourth-degree laceration repair. International Urogynecology Journal, 21(3), 353–358. https://doi.org/10.1007/s00192-009-1042-3
• Ruyak, S. L., Migliaccio, L., Levi, A., Albers, L. L., & Patel, S. (2018). Role development in midwifery education: A place for simulation. Midwifery, 59, 141-143. https://doi.org/10.1016/j.midw.2018.01.021
• Scholes, J., Endacott, R., Biro, M. S., Bulle, B., Cooper, S., & Miles, M. (2012). Clinical decision-making: midwifery students’ recognition of, and response to, post partum haemorrhage in the simulation environment. BMC Pregnancy and Childbirth, 12(19), 2-12 https://doi.org/10.1186/1471-2393-12-19
• Sezer, B., & Elcin, M. (2017). Simulation in medical education. educational technology readings. Chapter 39. Sakarya University. https://www.researchgate.net/publication/318543216_TIP_EGITIMINDE_SIMULASYON
• Silf, K., Woodhead, N., Kelly, J., Fryer, A., Kettle, C., & Ismail, K. (2015). Evaluation of accuracy of mediolateral episiotomy incisions using a training model. Midwifery, 31(1), 197-200. https://doi.org/10.1016/j.midw.2014.08.009
• Smith, R., Gray, J., Raymond, J., Catling-Paull, C., & Homer, C. S. E. (2012, November). Simulated learning activities: Improving midwifery students’ understanding of reflective practice. Clinical Simulation in Nursing, 8(9), 451-457. https://doi.org/10.1016/j.ecns.2011.04.007
• Stitely, M. L., Cerbone, L., Nixon, A., & Bringman, J.J. (2011). Assessment of a simulation training exercise to teach intrauterine tamponade for the treatment of postpartum hemorrhage. Journal of Midwifery & Women’s Health, 5, 503-506. https://doi.org/10.1111/j.1542-2011.2011.00046.x
• Şen Aytekin, M., Kahraman, A., & Alparslan, Ö. (2022). Effect of simulation methods used for teaching epsiotomy to midwifery students: a systematic review. Journal of of TOGU Health Sciences, 2(2), 212-224.
• Terzioğlu, F., Kapucu, S., Özdemir, L., Boztepe, H., Duygulu, S., Tuna, Z., …, & Akdemir, N. (2012). Nursing students’ opinions about simulation method. Hacettepe University Faculty of Health Sciences Nursing Journal, 16-23 https://dergipark.org.tr/download/article-file/88610
• Tokuhara, K. G., Boldt, D. W., & Yamamoto, L. G. (2004). Teaching Suturing in a workshop setting: a comparison of several models. Hawaii Medical Journal, 63, 258-259. http://hdl.handle.net/10524/53520
• Trinh, A. T., Roberts, C. L., & Ampt, A. J. (2015). Knowledge, attitude and experience of episiotomy use among obstetricians and midwives in Viet Nam. BMC Pregnancy and Childbirth, 15, 101–106. doi:10.1186/s12884-015-0531-2
• World Health Organization (WHO). (2009). Nursing & Midwifery human resources for health, Global standards for the initial education of professional nurses and midwives. World Health Organization, Department of human resources for health, Switzerland. http:// www.who.int/hrh/nursing_midwifery/en/. (Date of access 02.05.2019).
• WHO a. (2018). WHO recommendation on episiotomy policy. https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/care-during-childbirth/care-during-labour-2nd-stage/who-recommendation-episiotomy-policy-0. Date of Access: 16.04.2019
• WHO b. (2018). Regional Office for Europe. Simulation in nursing and midwifery education. http://www.euro.who.int/pubrequest (Date of access: 09.05.2019)
• Woretaw, E., Teshome, M., & Alene, M. (2021). Episiotomy practice and associated factors among mothers who gave birth at public health facilities in Metema district, northwest Ethiopia. Reproductive Health, 18, 142
• Yılar Erkek, Z., & Öztürk Altınayak, S. (2021). The effect of simulation teaching technique on the improvement of episiotomy performance skills and state anxiety of midwifery students in Turkey: RCT. Clinical Simulation in Nursing, 54, 62–69